Care of the Patient with Acquired Brain Injury in Latin America and the Caribbean.

Traumatic brain injury and stroke are the leading causes of death and disability in Latin American and Caribbean countries. Specific characteristics, models of health care systems, and risk factors may influence the patient's outcome in this region. Relevant literature suggest that important delay problems exist in seeking care, reaching care, and receiving care in patients with acute neurologic injuries.

An International Perspective of Transition of Neurological Disease: The Latin American and the Caribbean Region.

There are roughly 600 million people in the Latin America and the Caribbean region, of whom approximately 36% are living at or below the poverty line. According to this, neurologic injury disorders disproportionately affect this population, which faces not only most risk factors, but also has less developed health systems to deal with illness recovery. Further, most of the risk factors can be attributed to classic preventable cardiovascular risk factors, although there are important differences in demographics, socioeconomic status, and injury mechanisms that may influence the patient's outcome.

Pupillary Light Reflex Variability as a Predictor of Clinical Outcomes in Subarachnoid Hemorrhage.

Background: A change in the pupillary light reflex (PLR) is a sensitive indicator for detecting expanding intracranial lesions. Changes in PLR may be a prognostic marker for patients with intracranial lesions. The purpose of this analysis was to explore how PLR readings, size, constriction velocity (CV), dilation velocity (DV), Neurologic Pupil Index (NPi), and latency predict clinical outcome in patients with subarachnoid hemorrhage.

Correlation of Objective Pupillometry to Midline Shift in Acute Stroke Patients.

Background: Pupillary dysfunction is recognized as a sign of acute neurological deterioration due to worsening mass effect in patients with hemispheric strokes. Recent neuroimaging studies suggest that horizontal displacement of brain structures may be more important than vertical displacement in explaining these pupillary findings. Pupillometers allow objective and standardized evaluation of the pupillary light reflex.

The Cue-Response Theory and Nursing Care of the Patient With Acquired Brain Injury.

The cue-response theory is herewith proposed to replace the coma cue-response conceptual framework as a nursing theory for care of patients with acquired brain injury (ABI). After ABI, nurses assess patients and develop an understanding of their condition by interpreting meaning from physiologic and observational or behavioral cues. These interpretations form the basis for optimizing the timing of discrete nursing interventions; the outcome of which influences the trajectory toward recovery or toward secondary brain injury.

Differentiate the Source and Site of Intracranial Pressure Measurements Using More Precise Nomenclature.

Background: Intracranial pressure (ICP) monitoring is fundamental for neurocritical care patient management. For many years, ventricular and parenchymal devices have been available for this aim. The purpose of this paper is to review the published literature comparing ICP recordings via an intraventricular catheter or an intraparenchymal (brain tissue) catheter.

Secondary Brain Injury: A Concept Analysis.

Background: Traumatic brain injury and cerebrovascular disease may lead to motor, behavioral, and/or cognitive disabilities. The associated neurologic and vascular damage triggers a chain of events that lead to a secondary brain injury (SBI), a preventable cause of adverse neurological outcomes. Proper prevention of these factors may limit undesirable outcomes.